Careers in Communication Health: Where Will Your Degree Take You? (Part Three)

Communication health professionals working in private practice often enjoy more flexibility and freedom than those in public service, but their workload can also be less consistent.

By Riana Topan, Communications Assistant, SAC.
This article was originally published in the spring 2015 issue of Student Speak.

You’ve already made the decision to become a communication health professional, but do you know where you want to work after graduation? This article is Part Three of our “Careers in Communication Health” series, designed to give you a glimpse into real-life careers in speech-language pathology and audiology across different settings. Part One looked at what it’s like to work in a medical setting as a hospital-based clinician and Part Two focused on education-based communication health professionals. Part Three, below, explores a day in the life of communication health professionals who work in private practice.

Private clinics make up an important part of the Canadian health-care system. Hundreds of communication health professionals work in private settings across the country, working with individuals of all ages to improve their quality of life.

To get a sense of what it’s like to work in private practice, we talked to three professionals — one speech-language pathologist, one audiologist and one communication health assistant — about their typical workdays. All three had initially planned to pursue careers in other fields, but eventually ended up in communication health. And they couldn’t be happier about where they are now.

Starting Out

Paula Moss, S-LP(C), had originally thought about studying medicine but switched to speech-language pathology instead. She took the first job she was offered upon graduating, splitting her days between a head injury clinic and specialized preschools, before working at a community hospital outside of Toronto. Now, she primarily works with children and adults who are on the autism spectrum or who have significant learning disabilities, though she maintains a clinical interest in stuttering.

Moss is grateful for her early experience at the hospital: “My community and hospital colleagues were wonderful mentors and helped me hone my skills in the field of fluency. They taught me how to work with non-verbal and minimally-verbal young children. I couldn’t have learned what I did without the wonderful mentoring from more experienced clinicians in and around Toronto.” The position provided Moss with the time she needed to develop her skills and to choose an area of focus. She eventually left to open her own private practice with a clinical psychologist she worked with at the hospital.

Jillian Ryan, Aud(C), actually worked as a nutritionist for a year after earning her undergraduate degree, and then decided to study audiology. She landed her first job working in a private practice almost immediately upon graduating. “I was picky about my first job because I saw it as an extension of my training. I wanted a ‘mentor’ audiologist who would further help develop my skills; those you don’t get within a classroom. Thankfully, there were lots of options to choose from and I went into private practice as it allowed for in-depth rehabilitation as well as diagnostic audiology,” Ryan explains.

Like Moss, Ryan ultimately decided to open her own private practice, partly so she would have more flexibility and control over her work. “After years of learning various aspects of audiology I felt I wanted to create my own patient care model, run aural rehabilitation classes and determine my own schedule.” She hasn’t looked back since making the decision in 2012: “It has been the best thing I have done. I love what I do.”

Cheryl Booker, a communicative disorders assistant (CDA) in Hamilton, Ontario, planned to go into teaching after getting her undergraduate degree. However, she volunteered in classrooms while in school and discovered that teaching wasn’t for her: “I realized that I was more interested in being a resource for teachers, to help students achieve their full potential,” she explains. Booker completed the CDA program at Georgian College in 1993 and spent about a year looking for work before taking on a temporary contract with a school board.

For Booker, looking for a job was an eye-opening, and sometimes difficult, experience. Two decades ago, “the idea of an interprofessional team in speech or audiology was relatively new; not everyone saw the benefit of having staff that could support S-LPs in therapy.” Booker now works at a private practice part-time to supplement her primary position at the McMaster Children’s Hospital, having gained the clinical skills and confidence she needed to branch out into the private sector from her experience at a community health centre in west Toronto. She genuinely enjoys what she does: “I’m so thrilled that I found this field that I knew very little about.”

All in a Day’s Work

After spending years working long hours to set up and effectively market her private practice (“the equivalent of three jobs at one point”), Moss now spends three days each week at work. She frequently spends a fourth day working with community agencies and takes a lot of paperwork home with her, since the nature of her patient and client base requires extensive documentation. Moss also devotes a lot of time to professional development: “I spend many hours looking for resources and new research, seeking out people with expertise and looking at the latest in technology. I believe you’re never too old to learn!”

Ryan’s varied days usually run from 9 a.m. to 5 p.m. during the week, and consist of seeing 8–9 patients or clients each day. She performs diagnostic assessments and hearing aid evaluations and fittings, engages in product discussions and follows up with those who already have hearing instruments. These follow-ups ensure her patients and clients are receiving appropriate counseling and benefiting from their amplification. Ryan also completes assessments for cochlear implants, hosts lunchtime learning sessions with family physicians and offers education sessions to long-term care facilities to teach staff and residents about amplification and hearing needs.

Outside of her regular job at the hospital, Booker sees 1-2 clients during evenings or on weekends. These sessions require her to allocate time for preparation and to do follow-ups with the supervising S-LP. In her opinion, the best part about her job is knowing she makes a difference. “The most rewarding aspect is seeing the change both in the children I work with and their families.” Her clients have made a difference in her life, too. “I also feel I am still learning all the time, from my clients and their families as well as the great clinicians I have worked with.”

What to Expect

Communication health can certainly be an emotional line of work. For Ryan, the most rewarding part of her job is being a part of her patients’ successes. “I love helping them become better communicators, and getting to know them and their families. We laugh and cry a lot… it’s truly wonderful!” Moss admitted that she still cries each time she receives a thank you note. “It’s wonderful to see clients who we thought would never talk become radio presenters and high school valedictorians, or when a person who stuttered so severely she asked me to find a course at university in which she didn’t have to talk, goes on to become a doctor.”

Of course, that’s not to say that working in private practice doesn’t come without its challenges. Both Booker and Ryan noted how difficult it has been to understand the business aspect of providing private services. Booker said without hesitation that “the ‘business’ side of private practice work is by far the most difficult.” The second hardest part is the unpredictability: “It’s stressful when you don’t have as many clients as you want or need. The number of clients you have often goes up and down as people reach the limits of the medical benefits they have through work.” Ryan also found she had to learn a lot of business management on the job, since in her experience, “Canadian university programs do not provide enough teaching in the area of private practice.”

Ryan said that the hardest part of her job is not being able to help everyone. “You may realize that amplification will improve someone’s quality of life, but they may not be ready for it. It’s frustrating when you know how much they can gain but we have to remember that it’s our job to show them how they can have more independence, better communication, better relationships and more.” Still, she never tires of trying to improve her patients’ and clients’ quality of life.

How to Succeed in Private Practice

So what does it take to make it in the private sector? Booker says there are five skills communication health professionals need to succeed: critical thinking, adaptability, openness to feedback, patience and the ability to work with people who have varying, complex needs and learning styles. Her advice to students who want to start their own private practice is to get into business with clinicians who share similar values. Booker also emphasized the importance of being prepared for inconsistencies in your workload, since the number of clients and working hours can fluctuate greatly.

Ryan, meanwhile, says the single most important trait a professional needs in private practice is to be a good listener. “Get to know your patients, pay attention to their needs and, most importantly, listen to what they don’t say. Listen to your colleagues too; they might have a better way of doing things and you could learn something new.” Furthermore, Ryan suggests experiencing as many different aspects of the profession as possible to find your specific passion, and to never stop learning. “Continuing education is important as you grow as a clinician. The minute you think you know everything, you know nothing!”

After working in the private sector for 25 years, Moss agrees that being patient and understanding are key. Empathy is essential too: in her experience, making an effort to see things from a client’s perspective — ensuring that they don’t feel judged and that they know you care — can make a huge difference. And the most important thing Moss has learned is to value her work. “Too often we give things away for free or don’t charge for reports, trying to undercut other S-LPs… we need to act like professionals to be treated as such. Always value yourself, your time and what you do.”

In closing, Moss offers one final piece of advice to the next generation of private practice-based clinicians: learn how to market yourself and your business. “I did a marketing course when I went into private practice, and honestly it was best thing I ever did,” she explains. “You may be a great clinician but if you don’t promote yourself, if you don’t have business goals, you won’t succeed.” Moss recommends doing your best to connect with your community, by building up strong relationships with other professionals (like doctors and daycare staff, for example) through networking, offering workshops and giving presentations.

In fact, most of her referrals come from other clients or local physicians. Though her practice does advertise, it attracts new clients primarily through word-of-mouth. Moss concludes, “I don’t think we do enough to promote our profession. That doesn’t necessarily mean advertising; it means reaching out and showing people what you can do to help, to enable them to see the value of what you do.” Although this may sound like a lot of work, the communication health professionals we talked to thought the rewards were well worth it. The road to success isn’t always easy, but then, the best things in life rarely are.

Interested in starting your own private practice? Read our next PD Bulletin to find out how you can access a FREE webcast of Tracie Lindblad’s Lunch & Learn: Starting a Private Practice.

We hope you’ve enjoyed reading this three-part series and that you feel more prepared for what awaits you in your careers. Special thanks go to the following individuals for their assistance with Part Three:

Cheryl Booker, BA, CDACheryl is a communicative disorders assistant (CDA) who works part-time at Little Talkers, a private practice in Burlington, Ontario. She also works at the Chedoke Site of the McMaster Children’s Hospital and monitors CDA students on placement at Georgian College. Cheryl is a former president of the Communication Disorders Assistant Association of Canada.

Paula Moss, B.Med.Sc.(Hons), S-LP(C)Paula is a speech-language pathologist and one of the founders of Moss, Rowden, Freigang & Associates, a multidisciplinary practice in Brampton, Ontario.

Jillian Ryan, M.Sc., Aud(C)Jillian is an audiologist and the owner of NewLife Hearing Health Centre in St. John’s, Newfoundland and Labrador.

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